1. Field of the Invention
The present application generally relates to surgical instruments, and more specifically relates to incision guides and wound closure devices.
2. Description of the Related Art
During surgical procedures, incisions are often made, and these incisions must be closed at the end of the surgery. Over the years, many different techniques have been developed for closing surgical incisions. One common technique involves using sutures having a single knot or a series of knots. In recent years, surgical tacks have been used for closing surgical incisions, which reduces the amount of time required for closing incisions.
There are a number of disadvantages associated with using sutures for closing surgical incisions including an increased likelihood of wound infection due to a compromise of epidermal blood supply, high amounts of foreign body material, and tension on the wound edges. Using sutures and surgical tacks also typically results in poor aesthetics due to scar formation, stitch/tacker channels, and irritation of the skin.
In order to avoid the aesthetic problems outlined above, many surgeons now use an intradermal suture technique with absorbable or non-absorbable sutures. Unfortunately, this technique is time consuming, and requires non-absorbable sutures to be removed. In addition, even in instances where absorbable sutures are used, there remains a likelihood of granuloma formation.
A different technique for closing wounds or surgical incisions involves using glues such as a Dermabond adhesive. Typically, the Dermabond adhesive is used for small cuts and minor wounds, mainly on the face and head where skin tension is low. In the case of larger wounds, an exact approximation of wound edges is required to reduce the tension that may develop at the wound edges. Therefore, a two-layer closure of subcutis and dermis is required.
There have been a number of advances related to closing wounds without using surgical tacks or sutures. For example, U.S. Pat. No. 7,594,914 to Luchetti discloses an incision and closure device designed to repair skin wounds. The device includes a slide fastener that is fitted to a self-adhesive sheet that is attached to the skin surface. The slide fastener has a slider that includes a contact electrode for electrocoagulation and a cutting edge. As the slide fastener is opened, the slider simultaneously makes an incision by means of the cutting edge, severing both the flexible sheet and the skin beneath. For closing the incision, stringer tapes of the slide fastener interlock by the action of the slider, thereby bringing both the edges of the flexible sheet and the wound closure beneath into apposition. As the slider is drawn forward for closing the stringer tapes, electrical energy is applied by the electrode at the union site of the wound edges, which were previously brought into apposition by the mechanical action of the slide fastener, thus insuring that the edges become adhered in full depth as a result of electrical coagulation.
U.S. Pat. No. 3,933,158 to Haverstock discloses a skin closure means including a device for uniting and holding separable closure members and skin portions attached thereto accurately together for preventing separation. The device includes portions for accurately aligning and holding the separated edges of a skin wound or incision together during healing in such a way as to minimize or prevent the formation of scar tissue. The device includes closures that may be quickly and accurately applied, even under adverse conditions such as during emergencies and war conditions, and also under more controlled conditions such as in operating rooms and doctors' offices. Referring to FIG. 9 of Haverstock, a split tubular member 36 is used to hold opposing portions 28 and 30 together.
In spite of the above advances, there remains a need for an incision guide and wound closure device that reduces the length of surgeries, eliminates stitch channels, reduces tension on wound edges, minimizes or eliminate intracutaneous foreign body material, decreases infection rates, is easy to apply, results in a better cosmetic outcome, eliminates the need to remove stitches or tacks, enables large wounds or incisions to be easily closed, protects the wound by providing a sealing effect, and eliminates the need for additional wound dressing material. There also remains a need for an incision guide and wound closure device that may be repositioned atop a skin surface for ensuring proper alignment over a surgical site, and that provides an at least translucent or clear viewing area for observing the healing wound and the surrounding tissue.